In the human body, the spine generally includes 24 articulate vertebrae and 9 fused vertebrae in the sacrum and the coccyx. The cervical vertebrae are those vertebrae immediately inferior to the skull, located closest to the head and comprise the neck vertebrae. There are seven cervical bones and these bones are, in general, small and delicate. Their spinous processes are short, with the exception of C2 and C7, which have palpable spinous processes. Numbered top-to-bottom from C1-C7, atlas (C1) and axis (C2) are the vertebrae that allow the neck and head so much movement, and therefore are so important for allowing a person to perform day-to-day activities. For the most part, the atlanto-occipital joint allows the skull to move up and down, while the atlanto-axial joint allows the upper neck to twist left and right. The axis also sits upon the first intervertebral disk of the spinal column.
Every year neck pain affects millions of people. Most patients respond well to non-surgical treatments such as medication and physical therapy. However, a small percentage of patients may find nonsurgical interventions fail to relieve the pain. In these patients, symptoms may persist, which may include severe pain, neurologic dysfunction, neck and arm pain, and other symptoms may occur if a cervical intervertebral disc herniates. A disc herniates when some of the disc's gel-like center (the nucleus pulposus) bulges or ruptures through the tough tire-like outer ring (the annulus fibrosus) and presses on nerve roots or the spinal cord. This is called nerve or spinal cord compression.
If surgery is needed to alleviate nerve or spinal cord compression, the surgeon may perform a procedure called an anterior cervical discectomy and fusion. In this procedure, the surgeon makes a small incision in the front (anterior) of the neck to reach the cervical spine. Tissues and muscles are retracted to reveal the proper level in the cervical spine. The disc is removed and the space is filled with bone graft. A cervical plate is then screwed into the superior (top) and inferior (bottom) vertebral bodies, which stabilizes the cervical spine facilitating fusion and healing.